Eyelid surgery is the country's third most popular cosmetic surgery, surpassed only by liposuction and breast augmentation, according to the American Society of Plastic Surgeons.

The society's board-certified plastic surgeons performed 120,001 cosmetic eyelid surgeries in 1998, twice the number performed in 1992. Cosmetic eyelid surgery, blepharoplasty, is usually meant to reduce signs of aging, but among younger Asian Americans--especially those of Korean, Japanese, and Chinese descent--one method of blepharoplasty has gained significant popularity.

The majority of Asians have upper eyelids that appear to be taut from brow to lashes, rather than segmented by a crease. Asian blepharoplasty patients often request the creation of an upper eyelid crease, or "double eyelid," which uncovers a portion of the natural eye contours, making the eyes slightly larger, rounder and more amenable to makeup, as well as exposing more of the eyelashes.

Since non-Asians are typically born with double eyelids, this procedure has been construed as "Westernization," implying that Asians desire a more Caucasian appearance. But many in the Asian American community argue that the point isn't to look Western, but to look more like other Asians, many of whom have double eyelids naturally.

The notion of Westernization has sparked some criticism in the Asian American community. Authors Maxine Hong Kingston and David Mura are uncomfortable with the popularity of the surgery, and believe that altering eyes, features by which Asians are so easily identified, is an attempt to conceal or deny Asian heritage and conform to mainstream American beauty ideals.

"It's evidence of internalized racism," says Mura. "It really indicates something about the way in which Asians in America are indoctrinated by white standards of beauty. They feel less beautiful than those who fit the Caucasian standard of beauty." The main reason for that, Mura says, is the low representation of Asians in the media.

"People grow up watching the media, which is where people are beautiful and powerful. You see very few Asian faces. The message is: the way you look is not beautiful, or doesn't count, or doesn't even exist," he says. He believes the American media also account for much of the surgery's popularity in Asia.

"The power of the American media and American culture stretches all over the globe, and can cause people to devalue their own culture," says Mura.

Asian Americans who disagree with Mura's interpretation often point out that a large percentage of Koreans, Japanese, and Chinese are born with creased eyelids, although they certainly tend to be shaped differently than those of, say, Caucasians. In fact, in some regions, such as in southern China, as many as 70 percent are born with them. In addition, double-eyelid surgery is enormously popular in Asia, and has been considered attractive since well before the infiltration of Western media. Therefore, many argue, Asians seeking double eyelids are simply trying to look like the more attractive members of their own race.

"The desire for double eyelids has taken on a strange idea in the U.S. that Asian women want to look like Caucasians and that they desire [moon-shaped] eyes," says Shi Kagy, editor of AsiaMs, an online Asian beauty magazine (www.AsiaMs.net).

"In truth, Asian women want double eyelid folds that look like natural Asian type folds, and dislike the Caucasian type," she says.

For ten years, Dr. Jeffrey Ahn, Director of Facial Plastic Surgery at Columbia University Medical Center, has performed about 200 Asian blepharoplasties a year. He dispels the idea that his patients have tried to obscure their racial identity.

"I don't get a single patient asking to be 'Westernized,'" he says. "A lot of doctors still call it Westernization of the eyelid, which proves they have little understanding of the Asian patients." He stresses the importance of going to a surgeon who is accustomed to operating on Asian eyelids, because of the fundamental differences in facial anatomy.

"The surgeon should have aesthetic appreciation of the Asian eyelid," Ahn says. "A lot of the Caucasian surgeons think making it more like the Caucasian eyelids makes it more beautiful, and that's where unnaturalness results."

Ahn repeats, "I don't remember any Asian patient requesting to look less Asian."

Dr. John A. McCurdy, Jr., a plastic surgeon in Hawaii and author of the book "Cosmetic Surgery of the Asian Face," has performed thousands of Asian blepharoplasties over the last 20 years. He agrees that patients want to preserve their Asian characteristics--but says that wasn't always the case.

"A lot's changed over the years," McCurdy says. "It used to be that Asian girls, especially immigrant girls, were requesting the Westernization procedure. They wanted to look Caucasian. But now what they're requesting is a procedure to enhance the double eyelid while maintaining the other characteristics of the Asian eye."

In general, the hour-long process of Asian blepharoplasty involves excising a crescent- or tilde-shaped piece of skin out of the eyelid, removing some of the underlying fat, and then stitching the sides back together. There are different methods to accommodate variation in the height and curvature of the desired crease.

The average cost of the surgery in the U.S. is $1,734. During recovery, which takes about a week due to painful swelling and discoloration, the eyes must be treated with topical antibiotics and cannot be washed.

Ji Jeong Han, who had the procedure at age 15 by Ahn, is aware that non-Asians might misunderstand her intentions. "It's like if a white girl got cornrows, people would say she's trying to look black. People always think they are being copied," she says. "Obviously, white people have reason to think people want to look more like them. If you look at movies, you know how Hollywood stars have blond hair and perfect figures and all that."

She insists that she had the surgery primarily to correct her eyelashes and believes most Asians have the surgery for simple aesthetic reasons.

"All my Korean friends had it done just because they wanted bigger eyes," she says. Han, now 18, was encouraged by her grandmother, her mother, and her aunt, all of whom she describes as having naturally large eyes. "Before I got mine done, we used to look at Korean magazines or TV, and all the Korean actresses had big eyes or had had it done. They think it's prettier," she says.

Whatever the reason for the surgery, one thing seems certain: the pressure to conform the physical appearance to an ideal is not exclusive to either Western or Asian culture. And, in any attempt to meet a standard, there's always a risk of losing individuality.

"After I got it done, my parents said it looked nice because it was rounder," Han says, "but on the other hand something special was gone. Uniqueness." In fact, Han says, "I think people look better the way they're born."